Ep. 2 – Management of Heat Stroke & Other Heat Injuries

Heat injuries can range from minor heat rash to deadly heat stroke. Knowing how to identify and treat these conditions is essential for all prehospital providers. In this episode, learn to identify, treat and manage patients who present with heat injuries.

Show Notes

Heat injuries can range from minor heat rash to deadly heat stroke. Knowing how to identify and treat these conditions is essential for all prehospital providers. In this

A wide spectrum of illness which includes:

Heat Rash (prickly heat)

Heat Syncope

Heat Cramps

Heat Exhaustion

Heat Stroke

Heat Exhaustion

Heat exhaustion is a usually not life-threatening condition which results from exposure to heat. The thermoregulatory mechanisms of the body are still intact, but heat exhaustion may progress to heat stroke if not managed appropriately.

Signs/Symptoms

Malaise

Weakness

Dizziness

Headache

Nausea

Diaphoresis

Tachycardia

CBT usually < 40 °C (104 °F)

Normal Mental Status

May lead to heat stroke if not managed properly

Heat Stroke

Loss of the body’s normal thermoregulatory controls

Generally categorized into two groups

Exertional Heat Stroke

Classic Heat Stroke (AKA Non-Exertional Heat Stroke)

Classic Heat Stroke

Typically affects the extremes of age (Elderly and Infants)

Often develops over several days

Risk factors include:

Heat waves

Lack of air conditioning

Poor fluid intake

Children left in vehicles

Exertional Heat Stroke

Primarily affects athletes, military personnel, persons not acclimatized to local conditions

Onset is acute (usually hours)

Risk factors include

Poor fluid intake

Exercise during extreme weather

Football players (American Football)

Patient History

Obtaining a patient history is extremely important in cases of suspected heat stroke. A patient experiencing heat stroke will probably not be able to give an accurate history on their own, and bystanders may be your best source of information.

Benzodiazepines may be used to manage seizures, agitation or shivering secondary to active cooling.

DO NOT administer antipyretic medications such as acetaminophen, aspirin, or ibuprofen. They may worsen the patient’s condition.

Complications

Hypoglycemia

Seizures

Cardiac arrhythmias

DIC

ARDS

MODS

Differential Diagnosis

Neuroleptic Malignant Syndrome

Malignant Hyperthermia

Dantrolene is Tx for these

Anticholinergic Toxicity

Check pupils for dilation

Sepsis

Evaluate history

Thyroid Storm

Evaluate history

Enlarged thyroid is an indicator

Key Points

Heatstroke is deadly, but survivable if managed aggressively.

Ice water immersion is the most effective way to cool these patients, but if not available, use other methods such as evaporative cooling.

Cool the patient first, then transport.

Obtain a detailed history, and consider all differentials.

Prevention is the best way to manage heat injuries, educate the public whenever you can.

Thanks for checking out episode 2 of the podcast! Please let me know what you think of the show by leaving me an honest review in iTunes. Also, take a moment to subscribe to the site and ensure you don’t miss any new content. You can also follow me on Facebook and Twitter. I look forward to connecting with you in the very near future! Until next time, stay safe, and treat aggressively!